Obamacare enrollment: Deadline to sign up for January 1 coverage is here

By Holly Yan and Adam Aigner-Treworgy, CNN

Updated 9:38 AM ET, Mon December 23, 2013

Story highlights

CNN/ORC poll: Support for Obamacare has dropped to a record low

Most Americans must have some kind of health insurance in 2014 or will face a fine

"We screwed it up," Obama says of the HealthCare.gov website launch

The Obama administration says most of the technical issues should have been resolved

Time's almost up.

Monday is the deadline tor residents of most states to sign up for Obamacare if they want coverage starting January 1. And that's a big deal -- for two reasons:

Most Americans will be required to have some kind of health insurance in 2014 or face a fine.

There's also a lot riding on this politically. Monday will be a key test of President Barack Obama's attempt to overhaul the country's health insurance system.

Here's what you need to know about the Affordable Health Care Act coverage and Monday's deadline.

1) I'm confused. Haven't the enrollment deadlines moved around?

There's been a lot of confusion about the deadlines, and for good reason. Federal and state governments, as well as insurers, keep changing the dates, mainly to accommodate those blocked from completing enrollment due to technical problems.

Each consumer faces two deadlines: one by which to choose a plan, and another for making a payment.

If you live in one of the 36 states serviced by the federal enrollment website, HealthCare.gov, your best bet for getting hassle-free coverage in 2014 is to select a policy by end of the day Monday and pay your first month's premium by January 10.

2) Do I have to have coverage beginning January 1?

Not really.

The deadline to enroll in coverage to avoid a fine is March 31. That's the date that the program's open enrollment period officially ends. It won't reopen until October 15.

3) So why should I worry about the January 1 date?

If you're without health coverage now, or your plan ends December 31, you may want to get covered as soon as possible. You want to leave enough time for insurance companies to process your application.

And given all the shifting dates, Health and Human Services Secretary Kathleen Sebelius says consumers will have to be extra diligent.

"We advise consumers to call their insurance company to make sure that their payment has been received and that they are indeed enrolled," she said in mid-December.

4) Are the technical problems that plagued the site fixed?

The HealthCare.gov enrollment website got off to a chaotic start, with many users unable to enroll for days due to technical problems. "We screwed it up," Obama conceded Friday.

But the Obama administration said the issues should be resolved.

Americans are enrolling on HealthCare.gov at a pace of around 25,000 per day so far in December. And with few major website outages, it appears the website's worst technical problems may be in the past.

5) Will HealthCare.gov be able to handle a wave of new customers Monday?

HealthCare.gov was down for several hours before the president's remarks. So it remains to be seen if a last-minute surge in enrollments will have an impact.

Federal officials recently said that anyone who tries to sign up but encounters a problem with the website can qualify for a special enrollment period and gain coverage as soon as possible.

6) Who doesn't have to get health insurance?

Some Americans, such as those who can't afford it, will be exempt from the health insurance mandate, according to the Congressional Budget Office. For example, people who make so little they don't have to file a tax return are exempt.

People who are in this country without authorization are exempted, as are members of a federally recognized American Indian tribe who are eligible for services through an American Indian health care provider. People with certain religious beliefs that conflict with acceptance of the benefits of private or public insurance are also exempt.

7) Are the rules different in state-based exchanges?

If you are applying in one of the 14 states running its own exchange, you may have a different set of deadlines.

Rhode Islanders, for example, have until December 31 to pick a plan with coverage starting the next day. But they have to pay their first premium by January 6 and won't receive an ID card until they do.

In Washington, residents who try to apply by Monday but run into problems have until January 15 to pick and pay for a plan. Coverage will be retroactive to January 1.

California is giving residents until January 6 to pay, and Connecticut until January 10.

In other words, if you're looking at a state-based exchange, it's best to check with the exchange directly.

8) Are state-based exchanges seeing a similar surge?

Enrollments there have been mixed.

Covered California, one of the country's largest exchanges, has seen the highest numbers by far, with more than 100,000 people enrolled in private plans as of November 30. At his Friday news conference, Obama pointed to the state as a success story.

Yet in neighboring Oregon, the enrollment total at the end of November was just 44 people -- despite aggressive ad campaigns.

While some states are reporting increased interest in advance of Monday's enrollment deadline, the full effects of the increase won't be understood until after January 1.

9) What will Washington be looking at?

The more people enroll, the easier it will be to help Senate Democrats keep seats in 2014. And, of course, a booming enrollment would also improve Obama's legacy overall.